WEBVTT

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right arterial puncture is required to

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obtain arterial blood.

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For analysis of ph and blood gas values

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in trauma victims or patients with cardiopulmonary

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abnormality,

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three sites are available for obtaining arterial blood.

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The radio artery.

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Break your artery and femoral artery.

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The radio artery is preferred since it is easily

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accessible and it's puncture causes few

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complications.

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The radio artery and nerve pass along the radio side

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of the forearm from the elbow to the wrist.

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The site for puncture is at the distal portion of the

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radius because it is close to the surface centers away

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from any major nerves.

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The break your artery must be used when radio pulses

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are faint when approaching the break your

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artery in the anti cubicle fossa.

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Care must be taken to avoid the owner and radial

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nerves.

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The femoral artery should be used only when the other

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sites are unavailable,

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such as with severe trauma or when it is the

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only detectable pulse.

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The site for a femoral artery puncture is in the

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femoral triangle.

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The artery lies in between the femoral vein

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and nerve and can easily be detected by

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palpitating a sartorius muscle and the inguinal

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ligament and stepping off from either of these two

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points into the triangle.

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Great care must be taken to avoid damaging either the

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vein or the nerve.

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Either a three or five millimeter glass or plastic

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syringe.

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With lure lock is used.

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Glass syringes are easier to handle because the plunger

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moves more freely in the barrel,

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making it easier to detect pulsating arterial

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blood,

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the plastic syringes more available.

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Less expensive and offers reliable

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results If the blood sample is analyzed quickly

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to avoid diffusion through the plastic.

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Other equipment for arterial puncture includes

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alcohol swabs for prepping the skin,

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sodium heparin for coating the barrel and plunger.

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Come on A

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23 or 20 five gauge needle.

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Gauze patches,

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rubber hub,

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which is placed on the lure lock

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and a basin of ice.

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An arterial blood gas sample pack contain the

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necessary equipment can also be used

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before the puncture,

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prepare the glass or plastic syringe by wetting the

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barrel with Approximately .25 CCS of

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heparin.

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Do not draw air into the syringe and inject it

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into the heparin bottle.

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This procedure may alter the results of the blood gas

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analysis,

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gently pull and rotate the plunger back until the

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barrel is coated and eject the remaining solution.

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It is not necessary to leave Heparin in either the glass or

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plastic syringe

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to carry out radio artery puncture,

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extend the wrist,

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palm up a small towel may be

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placed under the risk to aid an extension.

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Next Locate a point for puncture

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approximately two cm proximal to the second wrist.

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Crease

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palpate the skin to locate the pulse.

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It is important to palpate across the risk to

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locate the area of strongest pulse.

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Follow the artery along its route to help

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visualize the anatomy.

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Prep the area with alcohol and relocate the

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artery with a single palpitating finger

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holding the syringe like a pencil,

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advance The needle at an approximately

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45 degree angle Bevel up.

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If there is difficulty in obtaining the sample,

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you may have to advance the needle further as the

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artery maybe deeper than expected,

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or rotate the syringes the bevel of the needle

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maybe against the wall of the artery.

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If the artery has rolled to the side,

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withdraw the needle slightly and advance it

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when using a glass syringe with a freely moving

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plunger entry into the artery will result

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in automatic filling of the syringe by way of the arterial

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blood pressure with a plastic

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syringe,

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the blood will have to be aspirated

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because a small gauge needle will cause slow filling into

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the barrel.

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Aspiration of even the glass syringe may be

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necessary to collect the sample.

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The following live sequence will show a radio artery

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puncture in a clinical setting.

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To inject a small amount of pain.

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The patient should first be given an explanation of the

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procedure to make the patient

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more comfortable.

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A local anesthetic such as 1% Zilla

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cane can be used

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locate the artery and inject zilla,

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Kane,

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subcutaneous lee in this area.

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Following an alcohol prep.

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Yeah.

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Okay.

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A little stick

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pull back on the needle to make sure you are not in the

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vein before injecting the solution.

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Right

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A glass syringes prepared by placing a number

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23 or 25 gauge needle on the lure

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lock and drawing in a small amount of heparin to

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coat the barrel and plunger

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prep the wrist and relocate the artery.

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Hold the bowel of the syringe like a pencil with a

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needle bevel up with a quick

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smooth motion entered the skin at approximately

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a 40 five degree angle,

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gradually advance the needle until you enter the lumen of the

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artery.

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Okay,

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allow a small amount of blood to enter the syringe.

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The pulse,

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little movement of the blood will assure you that you

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have entered the artery,

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stabilize the needle and pull back gently

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on the plunger to help fill the syringe

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222 and one half milliliters of blood is adequate

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for analysis.

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Be ready with your free hand to compress the artery with a dry

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gauze square as you withdraw the needle,

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we move the needle from the lure lock,

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making sure that there are no air bubbles in the sample

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and place a rubber lure tip cap on the

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syringe.

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Place the sample in ice,

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apply pressure on the Artery until all surface

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bleeding has stopped.

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This is usually 3-5 minutes.

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A plastic syringe may be used to collect the sample when no

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glass syringes available.

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Greater care must be taken in locating the artery by

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palpitation since the barrel of the syringe will not move

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freely in response to arterial blood

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prep the selected area and enter the skin.

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Yeah.

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Okay,

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mm hmm.

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Mhm.

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Pull back gently on the plunger to collect the sample

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preparation for lab analysis is the same as with the

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glass syringe,

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a lot of people will break through the scanner.

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Okay.

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Yeah.

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Okay well hold on.

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In cases of severe trauma,

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the femoral artery may be the only site where a pulse can be

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found because of the close proximity of

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the vein and nerve is important to locate the artery

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and bracketed between the forefinger and middle finger.

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The needle is then positioned between the fingers.

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Use a glass syringe and hold it at a more nearly right

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angle than for a radio puncture.

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The following scene shows ephemeral puncture in a trauma

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situation

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following palpitation

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and location of the artery prepped the area with alcohol.

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Hold the needle at a more nearly right

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angle than for a radio puncture and aim it into

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the clearly felt pulse.

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Following the collection of the sample.

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The syringe is sealed and iced because of the

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larger size of this artery,

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it is necessary to apply pressure for a greater length of

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time,

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usually five to 10 minutes.

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In summary the steps of the procedure are

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prepare the syringe by wetting the bow with heparin,

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palpate the area to locate the artery

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prepped the area with alcohol.

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Hold the syringe like a pencil at a 45°

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angle and advance the needle slowly until you

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enter the artery

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observed pulsar tile blood in the hub of the needle or in

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the syringe

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stabilize the needle and pull back gently on the

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plunger.

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Okay compress the artery.

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Following withdrawal of the needle,

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remove any air bubbles and seal the syringe.

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Place the sample on ice,

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continue compression of the artery until all surface

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bleeding has stopped.